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Trabeculotomy for Childhood Glaucoma

Surgery Overview

Trabeculotomy is a surgical procedure much like trabeculectomy. A piece of tissue in the eye's drainage angle is removed to create an opening. This new opening allows fluid (aqueous humor) to drain out of the eye. Trabeculotomy is a surgery for children only.

What To Expect

After surgery, drops that tighten (constrict) the pupil are used to keep the iris, which is the colored part of the eye, from blocking the new opening.

Why It Is Done

Trabeculotomy is a good choice for children who have glaucoma when the clear covering (cornea) over the iris is cloudy.

For children, trabeculotomy or goniotomy are preferred over trabeculectomy, because they are less invasive and less likely to cause cataracts. They also do a better job of lowering eye pressure in children who have glaucoma.

How Well It Works

One year after surgery, trabeculotomy was successful for more than 80 out of 100 children who didn't have glaucoma at birth.footnote 1

Risks

The most common problem after trabeculotomy is scarring of the new opening in the eye. Scarring prevents fluid from draining out of the eye. Other complications of surgery may include:

  • Severe blurring of vision for several weeks (common).
  • Bleeding in the eye.
  • Extremely low pressure in the eye, which may result in blurred vision from clouding of the lens (cataract) or fluid buildup under the nerve layer (retina).
  • Sudden, permanent loss of central vision.
  • Infection in the eye.
  • High pressure in the eye, causing the space in the front part of the eye (anterior chamber) to collapse. This condition is called malignant glaucoma and is rare.
  • Continued changes in the optic nerve (at the back of the eye) caused by glaucoma.

References

Citations

  1. Gagrani M, et al. (2020). Surgical interventions for primary congenital glaucoma. Cochrane Database of Systematic Reviews, 8: CD008213. DOI: 10.1002/14651858.CD008213.pub3. Accessed May 6, 2021.

Credits

Current as of: April 29, 2021

Author: Healthwise Staff
Medical Review:
Adam Husney MD - Family Medicine
Christopher J. Rudnisky MD, MPH, FRCSC - Ophthalmology
Heather Quinn MD - Family Medicine